University of Nottingham
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Cyclops feasibility projects on critical (intensive) care

1.


Principal investigator: Dr Andrew Norris, Nottingham University Hospitals Trust.

 

Project start year: 2017

 

Co-investigators: Professor Sergey Piletsky - University of Leciester. Dr Serhiy Korposh & Professor Steve Morgan - University of Nottingham.

Other partners: Prof Alexander Lanson, - University of Manchester; Dr Sanjukta Deb - King’s College London; Andrew Pritchard - B Braun Ltd.

Closed loop drug monitoring and delivery in intensive care

Lay summary

Survival in intensive care (IC) depends on having a comprehensive picture of a patient’s condition. Accurate continuous monitoring of vital parameters such as gas exchange, blood pressures and heart rate, temperature, ventilator mechanics, renal function, nutrition, and metabolism are available. However, continuous monitoring of drug levels is an unmet clinical need, the solving of which would provide a step change in IC practice and enable clinicians to provide optimised and individualized treatment of critically ill patients, with potential for reduced length of stay and of adverse events. Each patient day costs ~£1900.

Using novel optical chemical sensors, we propose to develop real-time blood level monitoring of sedative and analgesic drugs such as fentanyl, midazolam and propofol. This would enable precise and individualized monitoring of infusion rates or other dosing schedules to maintain continuously effective drug levels while minimizing adverse effects due to overdosage and accumulation. This is particularly important in drugs which have a narrow therapeutic window, or those with significant toxic side effects, for example, aminoglycosides and ciclosporin, if not administered correctly, can induce hearing loss and kidney failure.

 

2.

Principal investigator:  Professor Declan Bates, University of Warwick

Project start year: 2017

 

Co-investigators: Dr Don Sharkey - Nottingham University Hospitals Trust,  Professor Jon Hardman - School of Medicine, University of Nottingham

 

Other partners: Medtronic / Philips Research / Draeger

Investigation of closed-loop ventilation strategies for neonatal ICU patients using computational simulation

Lay summary

Ventilated critically ill newborn babies are prone to sudden and large changes in their respiratory state, requiring frequent and rapid interventions by ICU staff.  If not acted on promptly, these can increase the risk of brain injury or eye disorders resulting in long-term disabilities and blindness. Closed-loop ventilation control modes have the potential to simultaneously improve patient care and reduce staff workload, by automatically adapting ventilator settings in response to changes in the physiological state of the patient. To date, however, such closed-loop technologies have only been applied to the care of adult ICU patients.

We will extend and adapt a computational simulation platform that has been developed by the investigators over the past 10 years, so that it can accurately represent the unique (patho) physiology of mechanically ventilated neonatal patients.Using extant and prospectively acquired date we will validate the capability of our simulator to replicate the responses of individual newborn babies to a variety of changes in mechanical ventilator settings. Once validated, the simulator will be used to investigate the feasibility of developing closed-loop control algorithms that are tailored to the specific requirements of neonatal patients. Throughout the project, we will engage with our industrial partners (Medtronic, Philips Research, etc) to expedite the transfer of our closed-loop control technologies into the next generation of mechanical ventilators. On completion of the feasibility study, we will write a large-scale EPSRC/MRC grant application that will provide the resources to fully realise the many potential clinical and industrial applications of this work.

 

Room 811, Tower Building, University Park, Nottingham, NG7 2RD. Tel: 0115 74 86695

Email: email@cyclops-network.ac.uk